Factors influencing lymph node skip metastasis in colorectal cancer: a retrospective study.

BACKGROUND: The risk factors for lymph node skip metastasis (LNSM) have not been thoroughly clarified in patients with advanced colorectal cancer (CRC). This study aimed to identify the risk factors for LNSM in CRC patients who underwent laparoscopic radical resection with D3 lymphadenectomy. METHODS: This retrospective cohort study included a total of 167 consecutive patients who underwent laparoscopic radical resection with D3 lymphadenectomy for CRC between April 2005 and June 2017. The patients were sorted into the LNSM-positive (skip+ group) and LNSM-negative (skip- group) groups. Logistic regression was used to identify the risk factors for LNSM. RESULTS: Compared with the skip- group, the frequency of tumour size <5 cm, pT1-2 stage, and pN1 stage were significantly higher in the skip+ group (tumour size <5 cm: 68.8 versus 46.7%, P = 0.025; pT1-2 stage: 18.8 versus 4.4%, P = 0.012; pN1 stage: 78.1 versus 57.0%, P = 0.028), respectively. Multivariate logistic regression analysis revealed that pT1-2 stage (odds ratio (OR) = 4.3, 95% confidence interval (CI): 1.1-16.6, P = 0.034) and pN1 stage (OR = 2.6, 95% CI: 1.1-6.8, P = 0.047) were independent risk factors for LNSM. CONCLUSIONS: pT1-2 stage and pN1 stage are significantly associated with LNSM. Radical D3 lymphadenectomy should remain standard practice for CRC.

Effects of simvastatin and atorvastatin on biochemical and hematological markers in patients with risk of cardiovascular diseases.

OBJECTIVE: This study aimed to investigate the effects of simvastatin (SVS) and atorvastatin (AVS) on the biochemical and hematological markers in patients with risk of cardiovascular diseases. METHODS: One hundred and fifty outpatients were enrolled from the Department of Cardiology. Patients were treated with AVS or SVS. The lipids and hematological parameters were measured at baseline and after 4-week treatment, and the risk factors of cardiovascular diseases were recorded. RESULTS: After 4-week treatment, the lipids significantly changed. However, for hematological parameters, only mean platelet volume (MPV) significantly decreased after statins treatment (SVS: t = 68.748, P = 0.000; AVS: t = 39.472, P = 0.000), and the extent of decline was similar between SVS group and AVS group (t = 1.063, P = 0.289). There were no correlations between MPV and lipids. SVS and AVS had comparable effects on the lipid parameters after 4-week treatment, and there were no significant correlations of ΔMPV with the Δtotal cholesterol, Δhigh density lipoprotein-cholesterol, Δlow density lipoprotein-cholesterol, Δtriglyceride, Δapolipoproteint A1, Δapolipoproteint B and Δlipoproteint (a) after treatments (all P > 0.05). CONCLUSION: After statins treatment, the lipids significantly change; only MPV significantly decreases among hematological parameters, but it has no relationship with lipids reduction. The synthetic atorvastatin has similar effects to native simvastatin in the management of patients with risk for cardiovascular diseases.